Provider Demographics
NPI:1043281967
Name:CLEMENTS, ROSIMERI CRISTINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROSIMERI
Middle Name:CRISTINA
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 WAYMONT CT
Mailing Address - Street 2:STE 111
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3572
Mailing Address - Country:US
Mailing Address - Phone:407-804-8975
Mailing Address - Fax:407-650-3152
Practice Address - Street 1:325 WAYMONT CT
Practice Address - Street 2:STE 111
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3572
Practice Address - Country:US
Practice Address - Phone:407-804-8975
Practice Address - Fax:407-650-3152
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6091103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54524AMedicare ID - Type UnspecifiedPROVIDER ID NUMBER